Catsburg Chelsea, Kim Ryung S, Kirsh Victoria A, Soskolne Colin L, Kreiger Nancy, Rohan Thomas E
From the Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (CC, RSK, and TER); Prevention and Cancer Control, Cancer Care Ontario, Toronto, Canada (VAK and NK); the Dalla Lana School of Public Health, University of Toronto, Toronto, Canada (VAK and NK); the University of Alberta, Edmonton, Canada (CLS); and the Faculty of Health, University of Canberra, Canberra, Australia (CLS).
Am J Clin Nutr. 2015 Apr;101(4):817-23. doi: 10.3945/ajcn.114.097659. Epub 2015 Feb 11.
Evidence for a role of dietary risk factors in the cause of breast cancer has been inconsistent. The evaluation of overall dietary patterns instead of foods in isolation may better reflect the nature of true dietary exposure in a population.
We used 2 cohort studies to identify and confirm associations between dietary patterns and breast cancer risk.
Dietary patterns were derived by using a principal components factor analysis in 1097 breast cancer cases and an age-stratified subcohort of 3320 women sampled from 39,532 female participants in the Canadian Study of Diet, Lifestyle and Health (CSDLH). We conducted a confirmatory factor analysis in 49,410 subjects in the National Breast Screening Study (NBSS) in whom 3659 cases of incident breast cancer developed. Cox regression models were used to estimate HRs for the association between derived dietary factors and risk of breast cancer in both cohorts.
The following 3 dietary factors were identified from the CSDLH: healthy, ethnic, and meat and potatoes. In the CSDLH, the healthy dietary pattern was associated with reduced risk of breast cancer (HR for high compared with low quintiles: 0.73; 95% CI: 0.58, 0.91; P-trend = 0.001), and the meat and potatoes dietary pattern was associated with increased risk in postmenopausal women only (HR for high compared with low quintiles: 1.26; 95% CI: 0.92, 1.73; P-trend = 0.043). In the NBSS, the association between the meat and potatoes pattern and postmenopausal breast cancer risk was confirmed (HR: 1.31; 95% CI: 0.98, 1.76; P-trend = 0.043), but there was no association between the healthy pattern and risk of breast cancer.
Adherence to a plant-based diet that limits red meat intake may be associated with reduced risk of breast cancer, particularly in postmenopausal women.
饮食风险因素在乳腺癌病因中所起作用的证据并不一致。评估整体饮食模式而非孤立地评估食物，可能能更好地反映人群中真实饮食暴露的本质。
我们利用两项队列研究来识别并确认饮食模式与乳腺癌风险之间的关联。
通过主成分因子分析，从1097例乳腺癌病例以及从加拿大饮食、生活方式与健康研究（CSDLH）的39532名女性参与者中抽取的3320名按年龄分层的女性亚队列中得出饮食模式。我们在全国乳腺筛查研究（NBSS）的49410名受试者中进行了验证性因子分析，其中有3659例新发乳腺癌病例。在两项队列中，均使用Cox回归模型来估计所推导的饮食因素与乳腺癌风险之间关联的风险比（HR）。
从CSDLH中识别出以下三种饮食因素：健康型、民族特色型和肉薯型。在CSDLH中，健康饮食模式与乳腺癌风险降低相关（高五分位数与低五分位数相比的HR：0.73；95%可信区间：0.58，0.91；P趋势 = 0.001），而肉薯饮食模式仅与绝经后女性风险增加相关（高五分位数与低五分位数相比的HR：1.26；95%可信区间：0.92，1.73；P趋势 = 0.043）。在NBSS中，确认了肉薯模式与绝经后乳腺癌风险之间的关联（HR：1.31；95%可信区间：0.98，1.76；P趋势 = 0.043），但健康模式与乳腺癌风险之间无关联。
坚持以植物性食物为主、限制红肉摄入的饮食可能与乳腺癌风险降低相关，尤其是在绝经后女性中。
